N.Y. PBH Law § 4012-A

§ 4012-a. Hospice supplemental financial assistance program for\npersons with special needs. 1. Notwithstanding any provision of law or\nregulation to the contrary, an additional amount may be added to a\nhospice's rate pursuant to the medical assistance program, subject to\napproval by the state director of the budget, for purposes of enabling\nsuch hospice to provide care and services to persons with special needs,\nafter a determination that such care cannot be appropriately provided at\nthe rates of payment established pursuant to federal criteria.\n 2. "Persons with special needs" as used herein shall include persons\nwith acquired immune deficiency syndrome and other illnesses or\nconditions, which require a more costly or intensive level of care than\ntypically provided, and persons receiving care in a hospice residence.\nSuch other illnesses or conditions shall be specified in regulation by\nthe state hospital review and planning council.\n 3. In order for a hospice to obtain additional medicaid payment as\nprovided for in this section, the hospice shall submit cost information\nas required by the commissioner, in consultation with the commissioner\nof social services, which justifies additional medicaid expenditures,\nincluding a demonstration that adequate care to persons with special\nneeds cannot be provided within the rates of payment established\npursuant to federal criteria. In addition to demonstrating that the\nhospice is certified and in good standing with all applicable\nregulations and requirements, the hospice shall also demonstrate that it\nshall:\n (a) utilize such additional payment to provide services to persons\nwith special needs;\n (b) shall undertake reasonable efforts to maintain financial support\nfrom public and community contributed funding sources;\n (c) shall make every reasonable effort to collect payments for\nservices from third party insurance payers, governmental payers and\nself-paying patients; and\n (d) shall establish a reasonable relationship between costs and\ncharges, or establish charges at approximate costs.\n 4. The commissioner, in consultation with the commissioner of social\nservices, is authorized to submit for approval and adoption by the state\nhospital review and planning council such regulations as necessary to\neffectuate the provisions of this section.\n 5. The commissioner shall establish a rate for persons receiving care\nin a hospice residence, and may by regulation specify additional\nstandards necessary to ensure that the provisions of this section\npromote medical assistance recipients access to hospice residence care\nincluding; (a) that such recipients are otherwise unable to\nappropriately receive hospice care in their own home; and (b) the\nprovision of supplemental financial assistance will promote the\nefficient delivery of appropriate, quality, cost-effective services.\n